Acromegaly Treated with Chlorpromazine

Kolodny, Howard D.; Sherman, Lawrence; Singh, Amarjit; Kim, Sooseng; Benjamin, Fred

doi:10.1056/nejm197104152841504

Cited by 43 publications

(9 citation statements)

References 12 publications

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“…Since we had evidence suggestive of hypothalamic dysfunction, we attempted pharmacologie blockade of the releasing factors by the administration of neuroleptic agents known to interfere with the hypothalamic catecholaminergic mechanisms subserving RF/pituitary function in animals and man (Hokfelt 8c Fuxe 1972;Sherman 8c Kolodny 1971;Kolodny et al 1971). The observation that GLD was associated with hypothalamic derangement led us to reason further that a compound which specifically and selectively acts as a cerebral dopaminergic blocking agent (Andén et al 1970;McCann et al 1972;Porter et al 1972) might be efficacious in the treatment of the disease.…”

mentioning

confidence: 99%

Diencephalic Involvement in Generalized Lipodystrophy: Rationale and Treatment With the Neuroleptic Agent, Pimozide

Corbin¹,

et al. 1974

Acta Endocrinologica

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Our results indicate that generalized lipodystrophy (GLD) possesses as one of its manifestations, diencephalic neuroendocrinopathy. It has been postulated that deranged hypothalamic catecholaminergic mechanisms lead to the hypersecretion of hypophysiotrophic hormones that are detectable in the peripheral circulation. Initial treatment of a pre-puberal GLD patient with chlorpromazine was unrewarding. Chronic treatment of the same patients with the selective dopaminergic blocking agent, pimozide, eliminated corticotrophin releasing factor and luteinizing hormone releasing factor activities from the general circulation. Pimozide treatment ameliorated most of the distorted blood chemistry profile, led to return of facial subcutaneous fat, and elimination of cutaneous hyperpigmentation, fever, abdominal pain, hypertrichosis, oilness of hair, scaliness of skin and to a state of general well-being.The results of these studies, structured within the framework of our present knowledge concerning hypothalamic neurotransmitter/releasing hormone physiology, support the concept of diencephalic involvement in GLD and may provide a guideline to effective therapy.

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mentioning

confidence: 99%

Diencephalic Involvement in Generalized Lipodystrophy: Rationale and Treatment With the Neuroleptic Agent, Pimozide

Corbin¹,

et al. 1974

Acta Endocrinologica

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“…Furthermore, it has been shown that the combination of estrogen and phenothiazine administration evokes prolactin release in the rat [Meites, 1970;N icoll et al, 1970]. However, phenothiazine administration in the rat [Muller et al, 1967] and in the human [Kolodny et al, 1971] suppresses pituitary GH release. Experiments reported here show that the radioimmunoassay for rabbit GH measures relatively high hormone levels in the serum from estrogen-primed ani mals which fall dramatically upon intravenous injection of the pheno thiazine, chlorpromazine, and are undetectable for over 1 h. These data suggest that if estrogen and chlorpromazine cause the release of prolactin in the rabbit, the prolactin does not significantly cross-react in the radioimmunoassay for rabbit GH.…”

Section: Discussionmentioning

confidence: 99%

Physiological Control of Growth Hormone in the Rabbit

McINTYRE

Odell²

1974

Neuroendocrinology

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All experiments utilized blood samples obtained bychronic right atrial catheters. Growth hormone measurements, made by specific radioimmunoassay, showed that fasting and estrogen ad-ministration result in increased growth hormone secretion in the rabbit, although physical stress and exposure to cold do not. Insulin-induced hypoglycemia after fasting caused a decline in plasma growth hormone, and arginine infusion in the estrogen-primed rabbit resulted in an initial depression of plasma growth hormone followed by a renewed secretory phase. Electrical stimulation in the vicinity of the ventromedial nucleus of the hypothalamus caused an abrupt rise in serum growth hormone.

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“…1969) by MPA treatment. Al¬ though MPA has been reported to lower GH levels in acromegaly (Lawrence 8c Kirsteins 1970;Kolodny et al 1971), clinical improvement has not occurred and GH levels have increased or remained unchanged in most acromegalie patients treated with MPA (Malarkey 8c Daughaday 1971; Jackson 8c Ormston 1972). A blunting of arginine-induced GH secretion has been noted in some acromegalie patients treated with MPA (Lawrence 8c Kirsteins 1970) but not in others (Malarkey 8c Daughaday 1971; Jackson 8c Ormston 1972).…”

Section: Discussionmentioning

confidence: 99%

“…Lawrence 8c Kirsteins (1970) reported reductions in growth hormone (GH) levels and clinical improvement in three acromegalics treated for three to nine months with medroxyprogesterone acetate (MPA), a synthetic progestin. Kolodny et al (1971) reported one patient in whom GH levels de¬ creased after 12 days of MPA therapy. Malarkey 8c Daughaday (1971) observed a marked reduction in GH levels associated with clinical improvement in two of eleven patients treated with MPA for five to nine months.…”

mentioning

confidence: 99%

Unsuccessful Treatment of Acromegaly With Medroxyprogesterone Acetate

et al. 1974

Acta Endocrinologica

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Six patients with active acromegaly were treated with medroxyprogesterone acetate (MPA) in a dose of 10 mg four times a day for periods of two weeks to six months. Basal growth hormone (GH) levels, oral glucose tolerance tests, insulin tolerance tests, and arginine stimulation tests were obtained before and after one week, one month, three months, and six months of therapy. There were no significant changes in mean basal GH levels or in patterns of GH secretion following administration of glucose, insulin and arginine. Impairment in carbohydrate tolerance was observed in five of six patients during at least one evaluation period. MPA did not produce any therapeutic benefit in our patients with acromegaly and may have contributed to deterioration of the clinical condition.

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Acromegaly Treated with Chlorpromazine

Cited by 43 publications

References 12 publications

Diencephalic Involvement in Generalized Lipodystrophy: Rationale and Treatment With the Neuroleptic Agent, Pimozide

Diencephalic Involvement in Generalized Lipodystrophy: Rationale and Treatment With the Neuroleptic Agent, Pimozide

Physiological Control of Growth Hormone in the Rabbit

Unsuccessful Treatment of Acromegaly With Medroxyprogesterone Acetate

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